Latex symptoms and sensitisation in health care workers

Background: Natural rubber latex has become an important occupational healt h concern, particularly among health care workers, who for protection are r equired to wear latex gloves when at work. This study evaluated the prevale nce of latex-related symptoms and sensitisation among a large group of heal th care workers in Trieste hospitals. Methods: We evaluated the prevalence of latex-related symptoms in 1,165 health care workers, by means of a quest ionnaire, a medical examination, skin prick tests and IgE-specific evaluati on. We determined atopy and latex sensitivity by skin prick tests using a b attery of common inhalant allergens, a commercial latex extract (Lofarma Al lergeni, Milan) and individual skin puncture tests for each of the vegetabl es immunologically related to latex (potato, tomato, chestnut, banana, kiwi fruit). Associations between potential risk factors for latex allergy were assessed. Results: Glove-related symptoms were noticed on 17.2% of the nur ses (200) the majority of symptoms being mild dermatitis with itching and e rythema (120 subjects, 11.1%). Symptoms suggestive of IEE-mediated latex al lergy were found in 51 subjects: 35 (3%) complained of contact urticaria an d 16 (2.2%) complained of asthma and/or rhinitis. The resulting symptoms we re significantly related to skin prick tests that were positive to latex (o dds ratio (OR) = 11.89, 6.40-22.2), to personal atopy (OR = 2.15; 1.47-3.12 ), to familiar atopy (OR = 2.12; 1.48-3.03), to skin prick test positivity to related fruit (OR = 2.01; 1.16-3.46) but not to prick test positivity to common inhalant allergens (OR = 1.00; 0.71-1.39). Symptoms increased as a direct function of the time-usage of latex gloves and were more prevalent i n operating room staff. Conclusion: In this large cross-sectional study, gl ove-related symptoms and latex skin sensitisation appear to be substantial among health care workers. and are related to common signs of atopy. We str ess the need of preventive measures to avoid latex exposure when health car e workers are at risk of developing allergy symptoms.